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Old 09-07-2012, 06:54 AM   #1
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Question questions about ultrasound results

Hello! I am back after taking a break from reading the board (after being told several times there is nothing wrong with me from my doc). I have posted once before (http://www.healthboards.com/boards/thyroid-disorders/889177-my-story-course-hypo-questions-normal-my-normal.html) but now I am in need of your advice again!

I'm a 31 female and for the past year (at least) I have strongly suspected I may be hypothyroid or have some sort of hormone imbalance. I have been pursuing some sort of diagnosis for about a year now. My TSH has been all over the place but always remained "in range" (2.58, then 1.8, then 2.00 about 2 weeks ago) so none of the practitioners I have seen will test further. I have many of the symptoms and the most worrisome one for me has been lack of weight loss despite rigorous training with a personal trainer 3-5 days a week. I have pretty much done every diet in the book over the course of my lifetime and underwent gastric bypass surgery 11 years ago (lost weight but never got down to my "goal" and started steadily gaining again after my year anniversary). The brain fog/lack of short term memory is also scaring me as well.

My sister has Hashi's and my maternal aunt had her thyroid removed due to confirmed thyroid cancer (not sure which type but she underwent a few sessions of radiation even after the gland was removed.)

I finally switched docs a few weeks ago to an osteopath hoping that they would be more openminded, but was devastated when they told me my blood work came back "normal". After a minor breakdown in their office, they agreed to send me for a pelvic ultrasound (suspecting PCOS) and would throw in a request for a thyroid ultrasound at the same time to "ease my mind".

My pcos ultrasound came back normal (no pcos) but my thyroid scan reads as follows:

CLINICAL DATA: Thyroid nodule
TECHNICAL: Real-time ultrasound and color flow doppler were performed.
COMPARISON: None available
FINDINGS:
RIGHT LOBE: 5.8x1.6x1.6 (CC AP RL) centimeters
ISTHMUS: 0.5 centimeters thick
LEFT LOBE: 5.3x1.2x1.7 (CC AP RL) centimeters. There is a 6mm solid nodule in the mid lateral left lobe.
IMPRESSION: Mild imhomogeneity of the echotexture of the thyroid gland - 6 mm solid nodule on the left lobe.

1. Due to my family history and my symptoms, my osteopath is referring me to a General Surgeon for the nodule. I have an appointment I made a few months ago (just in case the osteopath didn't work out) but they are so booked up I can't get in until mid october. My ostepath did not want me to wait that long to get it checked out. So is the general surgeon really the next step? Is there another specialist I should see first?

2. My doc totally blew over the "mild imhomogeneity of the echotexture of the thyroid gland" part and did not even discuss it. From what I have read, is that a possible indication of Hashi's and I'm not crazy? Although I have asked repeatedly from my doctors, I have never been able to get a antibodies/free t3 test because my TSH has always been "normal". I did receive a free t4 test in february of this year and it was only 48% of range. I had a Total T4 done with my last TSH test last week and it was 5.7 (4.5-12.0). Does this ultrasound confirm that I do, indeed have some sort of problem with my thyroid that is causing my symptoms (I could post them but this is already getting to be a novel!)

3. My sister (who's own TSH has gotten up to above 10 while getting treated for hashi's- and works in the medical field with a lot of TSH-worshipping doctors) is baffled how I can have symptoms and nodule but "normal" bloodwork. Any ideas on what to tell her?

Thank you SOO much for reading my story and any guidance you can give me!
-erin

 
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Old 09-09-2012, 02:18 PM   #2
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Re: questions about ultrasound results

No, you don't see a general surgeon for thyroid issues, instead you can see an ENT--ontorongologist, one that removes many thyroids a week---and/or, you can see an endocrinologist. I don't think you are at the stage of needing a surgeon yet. The endo might be a better route (mine has an ultrasound machine in his office which is convenient).

That is too small of a nodule to even get a needle biopsy on, so you can either follow it over time for growth and changes with ultrasounds every year, (your thyroid as well because it is enlarged), or an endo can do this, and perhaps you can try to go on thyroid meds to see if it helps shrink the enlarged thyroid you have.

 
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